COX-2 inhibitors are a new generation of NSAIDs that are highly effective in reducing joint pain and inflammation as well as the joint stiffness associated with osteoarthritis. They cause fewer side effects involving the stomach than regular NSAIDs. For this reason, doctors often prescribe them for patients who are sensitive to regular NSAIDs. COX-2 inhibitors are available in tablets and liquids.

How COX-2 Inhibitors Work

COX-2 inhibitors block an enzyme in your body that produces prostaglandins. These are natural substances in the body that cause pain and inflammation. By blocking prostaglandin production, COX-2 inhibitors reduce pain and inflammation. Unlike regular NSAIDs, COX-2 inhibitors block less of the prostaglandin that protects the stomach lining, so they cause less stomach irritation and side effects. For this reason, COX-2 inhibitors are described as selective prostaglandin blockers.

Possible Side Effects of COX-2 Inhibitors

Some people may experience the same side effects with either regular NSAIDs or COX-2 inhibitors.

Bothersome Side Effects
  • stomach pain
  • back pain
  • diarrhea
  • deafness
  • headache
  • heartburn
  • stuffy or runny nose
  • nausea
  • rashes
  • sleeplessness
More Serious Side Effects
  • high blood pressure
  • migraine headaches
  • stomach pain with bleeding
  • swelling in feet or ankles
Possible Drug Interactions with COX-2 Inhibitors

Some of the drug interactions listed for NSAIDs are also possible with COX-2 inhibitors. Tell your doctor about all other drugs you are taking. It's even a good idea to let your doctor see your other prescription containers. Not all drugs in the categories listed below will react with COX-2 inhibitors - your doctor is the best judge. Always check with your doctor to be sure.

Drugs to Avoid With COX-2 Inhibitors
  • ACE inhibitors
  • Fluconazole
  • Lithium
  • NSAIDs, including aspirin
  • Warfarin